Digital Anticipatory Protocols at Triage to Improve ED Flow.
Implementing Digital Anticipatory Protocols at Triage to Improve Emergency Department Flow: A Before-After Study Protocol
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Tipo de estudo
Inscrição (Estimado)
Contactos e Locais
Contato de estudo
- Nome: Thomas Castelain
- Número de telefone: +41263061392
- E-mail: thomas.castelain@h-fr.ch
Estude backup de contato
- Nome: Youcef Guechi
- Número de telefone: +41263063142
- E-mail: youcef.guechi@h-fr.ch
Locais de estudo
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Canton of Fribourg
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Villars-sur-Glâne, Canton of Fribourg, Suíça, 1752
- Recrutamento
- Fribourg Cantonal Hospital
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Contato:
- Thomas Castelain
- Número de telefone: +41263061392
- E-mail: thomas.castelain@h-fr.ch
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Contato:
- Youcef Guechi
- E-mail: youcef.guechi@h-fr.ch
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Investigador principal:
- Youcef Guechi, MD
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
Inclusion Criteria:
- All patients over 18 years who registered at the admission desk during the study period.
Exclusion Criteria:
- Arrival by emergency medical services (ambulance or helicopter)
- Patient trajectory bypassing the standard nurse-led triage process
- Patient directly referred to another service of the hospital after triage (gynecology, ophthalmology, etc.).
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
|---|---|
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Phase 1 - Pre-intervention
Patients presenting to the emergency department between May 1st and July 31st, 2026.
Patients undergo standard triage assessment performed using the revised Swiss Emergency Triage Scale (SETS).
Disposition decisions are monitored using a digital tag in the electronic health records.
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Phase 2 - Post-intervention
Patients presenting to the emergency department between May 1st and July 31st, 2027.
Patients undergo triage with the addition of a new digital anticipatory protocol.
Disposition decisions continue to be monitored using the same digital tag.
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The intervention consists of adding digital checkboxes to the electronic triage system.
This provides nurses with formalized options for anticipated management based on patient acuity, aiming to encourage and document anticipatory actions while stimulating clinical reasoning.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Total Emergency Department Length of Stay (ED LOS).
Prazo: Through completion of the ED visit, up to a maximum of 72 hours.
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The time interval from the completion of the patient's administrative registration to their physical departure from the ED
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Through completion of the ED visit, up to a maximum of 72 hours.
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Left without being seen (LWBS)
Prazo: Through completion of the ED visit, up to a maximum of 72 hours.
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Proportion of patients who registered at the ED admission desk and left before receiving a medical screening exam or an evaluation by a physician
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Through completion of the ED visit, up to a maximum of 72 hours.
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30-day mortality
Prazo: Up to 30 days post-ED visit
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Assessed through institutional medical records to evaluate safety
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Up to 30 days post-ED visit
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Intesive Care Unit (ICU) transfers
Prazo: Up to 7 days post-ED visit
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Proportion of patients transferred to the Intensive Care Unit (ICU) immediately and within 7 days after the ED visit
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Up to 7 days post-ED visit
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Time From Triage Assessment to Disposition Decision
Prazo: Through completion of the ED visit, up to a maximum of 72 hours.
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The time interval, measured in minutes, elapsed from the beginning of the nursing triage assessment to the exact moment a definitive disposition decision (e.g., discharge, admission) is entered by the emergency physician. A disposition decision is operationally defined as the precise moment the attending emergency physician determines that active emergency care is complete. This includes the decision to transfer the patient to a hospital ward (for admissions) or the conclusion of clinical management (for discharges), even if the patient remains in the emergency department awaiting purely logistical arrangements, such as medical transport or family arrival. The measurement tool used to assess and timestamp this outcome is a standardized digital disposition decision tag integrated into the electronic health record. |
Through completion of the ED visit, up to a maximum of 72 hours.
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Time From Treatment Room Placement to Disposition Decision
Prazo: Through completion of the ED visit, up to a maximum of 72 hours.
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The time interval, measured in minutes, elapsed from when the patient is placed in an ED treatment room to the exact moment a definitive disposition decision (e.g., discharge, admission) is entered by the emergency physician. A disposition decision is operationally defined as the precise moment the attending emergency physician determines that active emergency care is complete. This includes the decision to transfer the patient to a hospital ward (for admissions) or the conclusion of clinical management (for discharges), even if the patient remains in the emergency department awaiting purely logistical arrangements, such as medical transport or family arrival. The measurement tool used to assess and timestamp this outcome is a standardized digital disposition decision tag integrated into the electronic health record. |
Through completion of the ED visit, up to a maximum of 72 hours.
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Youcef Guechi, MD, Hopital Cantonal Fribourgeois (HFR)
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Outros números de identificação do estudo
- Req-2026-00230
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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